Thong Bernard Yu-Hor, Pawankar Ruby, Park Hae-Sim, Abdul Latiff Amir Hamzah
Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore.
Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
Asia Pac Allergy. 2023 Sep;13(3):127-131. doi: 10.5415/apallergy.0000000000000114. Epub 2023 Sep 7.
(pneumococcus) is a significant cause of bacterial infections ranging from mild infections affecting the respiratory tract such as otitis media and sinusitis to severe diseases including bacteremia, pneumonia, and invasive pneumococcal disease (IPD) (eg, meningitis, septic arthritis, and endocarditis). Pneumococcal vaccines were first developed in the 1970s as capsular pneumococcal polysaccharide vaccines, which were T-cell independent and hence lacked immunologic memory. Subsequently in the year 2000, pneumococcal conjugate vaccines (PCV) conjugated to a protein to increase immunogenicity were developed and made commercially available. The increasing number of pneumococcal serotypes identified and the expanding pipeline of PCV vaccines with improved immunogenicity have significantly reduced the morbidity and mortality associated with IPD in high-risk patients. Pneumococcal vaccines also play an important role in the diagnosis and immunophenotyping of children and adults with inborn errors of immunity (IEI) given the increasing diversity/heterogeneity of IEI presenting with primary and/or specific antibody deficiency. Other than the quantitation of serotype levels in routine clinical care, other measurements of immune response including the functional activity of antibodies, antibody avidity, cell-mediated immunity, and immunological memory remain limited to clinical trials during vaccine development.
肺炎球菌是细菌感染的重要病因，其感染范围从影响呼吸道的轻度感染（如中耳炎和鼻窦炎）到严重疾病，包括菌血症、肺炎和侵袭性肺炎球菌病（IPD）（如脑膜炎、化脓性关节炎和心内膜炎）。肺炎球菌疫苗最早于20世纪70年代作为荚膜肺炎球菌多糖疫苗开发，这种疫苗不依赖T细胞，因此缺乏免疫记忆。随后在2000年，开发了与蛋白质结合以提高免疫原性的肺炎球菌结合疫苗（PCV）并投入商业使用。已鉴定的肺炎球菌血清型数量不断增加，以及免疫原性得到改善的PCV疫苗产品线不断扩大，显著降低了高危患者中与IPD相关的发病率和死亡率。鉴于先天性免疫缺陷（IEI）伴原发性和/或特异性抗体缺陷的表现日益多样化/异质性，肺炎球菌疫苗在患有IEI的儿童和成人的诊断和免疫表型分析中也发挥着重要作用。除了在常规临床护理中对血清型水平进行定量外，包括抗体功能活性、抗体亲和力、细胞介导免疫和免疫记忆在内的其他免疫反应测量仍仅限于疫苗开发期间的临床试验。
